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  • Lisa Tew

Anxiety


One of the hallmarks of Autism Spectrum Disorder (ASD) is anxiety. It is a factor that must be taken into account daily and maybe even hourly in the lives of adolescents and young adults with high functioning autism and Asperger’s. While anxiety can make progress toward employment and independence difficult, there are ways to manage or cope with it. A young person’s ability to cope with anxiety can make or break their goal of an independent future.

The first thing to consider is medication for anxiety. I encourage you to be positive about this and to work with their doctor to explore how medications may help your child to manage his or her anxiety. It requires patience and time to find an anxiety medication that is right for your child, but it can be extremely helpful so it is worth the effort. Some parents report that medication for anxiety is unhelpful or had unwanted side effects, so the idea of anxiety medication was abandoned. It is often the case that they tried only one or two types. But there are so many different types of anxiety medications that it may actually take several attempts to find the right kind for your child. Also, his or her needs may change over time. No one wants their child to take medicine long term, but if your child’s anxiety is very significant then you may need to explore this to set them up for success as they grow into adulthood.

Whether or not your child’s anxiety is improved by medication, he or she will need problem perspective, recognition and perspective regarding the level of their anxiety vis a vis their problem, and coping skills, to function as an independent adult. There must also be a level of understanding and cooperation for leaving their comfort zone to engage in new activities that will grow their futures, probably with your encouragement.

There is a lot to say about each of these, and therefore they are the subjects of separate blogs. However, here are some general concepts:

Problem perspective: Your child’s anxiety surrounding problems, and what they should say and do, depends on what kind of problem it is, and what level of problem it is. The theme here is positivity which I hope you are using as a signal word day in and day out with your child--please see the “Positivity” blog at this website; if you get resistance from your child then you can invoke “positivity” for the way you are approaching it! You may also find helpful advice on this through my book, 101 Positive Steps Toward Employment and Independence for Young Adults with Autism (Tew, Future Horizons, anticipated publication date October 2019). There are also a number of helpful points about “positivity” in Autism and Employment: Raising Your Child with Foundational Skills for the Future (Tew and Zajac, Future Horizons, 2018).

Regarding the kind of problem, it is often helpful and may reduce anxiety for a young person with high functioning autism or Asperger’s to put their problems into categories. This makes problems more manageable and helps them know how to respond appropriately. You the parent can model and talk about problems in this way day after day, helping your child to develop accurate perceptions of the type of problem that arises, and to reflect and respond appropriately. For example, if it is…

An accident?: “That’s okay”

A mistake by you or someone else? “I’ll do better next time” or “It’s okay, people aren’t perfect!”

Sometimes in life, things just happen!: “Oh well, these things just happen!”

On purpose to hurt or bother you?: “Please stop doing that”, or ask someone for help.

Ideally, after learning the categories well, you just prompt them with “What kind of problem is this?” and “So what should we say about it?” These categories may be overly simplistic for the adolescent or young adult, and while the simplicity may be helpful, you may also want to add one or two categories for your child if you see the need. Knowing what category the problem goes into and an appropriate response can be very helpful for reducing anxiety.

Another thing to consider with anxiety provoking issues or problems is having perspective on the problem. On a scale of 1-10, where is the problem on that scale, and how does that compare to their level of anxiety about the problem? For anxiety we often use a scale of 1-4 (1-none, 2-a little, 3-some, 4-a lot). Is their anxiety at a 4 (“ a lot”) for a problem that is generally considered to be only a 5 out of 10? How does your child’s anxiety over an issue compare to that of others or what would be common or appropriate? (I’m sorry you are anxious at a ‘4’ about this, it’s honestly more of a ‘1’ or ‘2’ for most people”). So, can they bring their anxiety down? They need coping skills for this.

We generally divide coping skills into “helpful” and “unhelpful” categories. It is unhelpful to avoid, to act out, to blame, to overfocus on interests, etc. Which coping skills are helpful varies from person to person, so your child should have a list of activities that he or she finds helpful to cope with problems or anxiety generally, and update it whenever needed. This list should be available in multiple locations so that it can be accessed easily.

The last point I want to make about anxiety is the issue of the “comfort zone”. Young people with high functioning autism or Asperger’s almost always have a strong preference for staying in their comfort zone, and leaving it can provoke anxiety. You can work with them over time to develop insights that help them know that:

Autism spectrum makes me more prone to both anxiety and the desire to continue to do what I know makes me feel comfortable.

I must learn to tolerate being uncomfortable to grow and develop to my potential.

I can do this with perspective and coping skills, and the support of the people who love me.

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